Interview with Anthony Almojera

Anthony Almojera is an FDNY EMS lieutenant and vice president of AFSCME DC37 Local 3621, the New York City Fire Department's EMS officers' union. He is the author of Riding The Lightning. A Year in the Life of a New York City Paramedic.

I asked Almojera about the differences in organized labour efforts between firefighters and FDNY EMS.

Almojera : EMS didn't really happen until the early to mid eighties. They had a 60-something-year head start of organizing, of coalescing around what it means to be a firefighter, what the job entails and what they need as a service. EMS in its infancy is only 50-years-old. As a matter of fact, this March is 50 years since the first medics hit the streets in New York City.

Even when it started to unionize and say -- "Hey, there's a thing called health and hospitals, and we should have a voice," it was still fractured. EMS in New York City is, multiple agencies responding to 9-1-1, the biggest of which is the fire department.

So in 1996, when the threat of closing down firehouses was around in conjunction with Giuliani wanting to privatize EMS, then, only then, did Fire say, 'well, listen, we need to keep our numbers up. We need to have "diversity", quote unquote, let's go and take over EMS.' And they did, but they didn't know what to do with us. You know, it's like a dog who catches the car, finally. They don't know what to do with the car if they catch it. They just chase after it.

It became a thing where they started doing CFR runs (a CFR run was a medical call that was assigned to a FDNY engine company whose members were trained to the NYS certified first responder level). They started doing more medical runs. Then when they had real issues with diversity through lawsuits they started poaching even more from the truly diverse service -- which is EMS.

The problem is EMS has been colonized. So the country that's been colonized never gets the abundance of resources. As a matter of fact, it gets taken from. And with EMS, the issue is you've never had the colonizer, the Fire Department ever advocate for EMS and its members. I've never heard one of their leaders come out and say, EMS deserves more money. From their union leaders. Only until very recently, post pandemic, you've heard the commissioner say, well, no, EMS needs to be fixed. And it's a shame because that pandemic would've gone a different way had people invested in EMS from the beginning.

Newman : So post-pandemic when so many medics have left – now is the time to re-invest ?

Almojera : We've lost over 1400 people since March of 2020. We're a service of about 4,000 people. So we've had over 1400 people who have either retired or quit, and it's going to be a lot more if there's a fire class that goes in (people leaving the EMS side to enter the Fire side of the department). And we're busier than ever. Before the pandemic, we would do 3000, 3500 calls a day, roughly. It would spike once in a while with a heat wave or New Year's, you know, the normal spikes.

Now we're doing 5,000 calls on a Tuesday in February. We're rarely under 4,500 calls a day. So the house of cards that was the medical system completely fell down. It exposed everything. More people than ever are tapping into 9-1-1 services for various reasons. And we're short-staffed. The burnout is real. And people are just sitting here going, well, I don't want to do this anymore.

Newman : So what's the career expectancy of a paramedic now ?

Almojera : Roughly 73% of my current workforce has less than five years experience.

Newman : How does your pay scale work ? How long do you have to work before you reach max pay ?

Almojera :  Like other city agencies? It's five years. But the problem is, and even though in the last contract we took a big jump, we were so far behind the other agencies, PD and Fire specifically, we're still approximately $30,000 behind in the top pay. So when they reach five years, a top pay firefighter, when you include some other things, it's roughly about $90,000 a year. Whereas the top pay for an EMT not including the overtime and stuff is roughly $58,000. So, you know, the bulk of the service is firefighters and EMTs. And there's a $30,000 gap. And then top pay for cops is in that ballpark too, you know, in the nineties. Top pay for Sanitation is in the nineties.

Sanitation is a hidden gem for a lot of people. We lose many members to Sanitation. Think about it. You're a medical professional. You're a paramedic. You went to school to save lives and the working conditions in the pay are so bad that you would rather go pick up garbage. I'm not diminishing. Often, by default, we compare ourselves to firefighters because we have the same patch. So a lot of people, including myself, sometimes say, Well I want what firefighters have. But I want what sanitation has. If you ever see a New York City Sanitation patch, it's a caduceus. They're the other health agency, and I want the same pay and benefits they have because it's much better.

I'm not diminishing what they do. It's hard work. And I don't want to walk around the city with tons of garbage. I'm not saying they don't deserve what they deserve. I just want the same. And that's the most frustrating thing about being a union leader in a world that is nothing but equality now. Every time you turn around, it's about equality. It's about recognizing groups that have been oppressed or silenced. And here you have a group that's been oppressed and run roughshod over for years, just asking for the same equality. I am not asking for $1 more and yet it still doesn't resonate with people.

Newman : What do you attribute that to ?

Almojera : I think, some of it is people don't understand what we do. I don't know if you're familiar with all the work I've done in the media. I wrote a book. I wrote articles for the New York Times. But all those things were done to try and educate the public that hey, the lights you saw when times were the darkest were the ambulance lights, and here's why that's important. Here's why you need us. And so I think what happened is for years, people didn't want to acknowledge paramedics and EMTs and that, oh, I don't need them. I'll never call an ambulance. Fire and PD is so ingrained in the psyche that they think, oh yeah, no, those are heroes. We'll need those people at some point. Everything you see on TV is a firefighter. You always see, and I've had this argument with photographers for newspapers, you always see when the firefighters are running with the kid, but they never take the photo of who they're handing the kid over to -- there's never a hand-off picture. Ever.

I always say, Hey, there's another component here you guys don't understand. And that component is just as vital. I think the public, if they acknowledge ambulances and paramedics, they acknowledge the fragility of life and the mortality that we all face. And I think there's a subconscious thing like, okay, we'll pay doctors and we'll begrudgingly pay nurses. We'll have to go. I may need them. Because that's what people think. We need to confront all the things in society and why we would need a paramedic. What used to be emergency care in what we do is now primary care. Because I go to people's homes – we haven't been to doctors for years because the healthcare system is broken. They don't have health insurance. They can't afford it. There's a thing where you're trying to go and reverse a disease process that started and so we have to acknowledge all those other things. And we don't. There's no will in this country anyway to want to fix those things. So, EMS is lumped in with them.

And people say, well, we'll just rely on this patchwork of providers. And when one of them want to charge $2,000 an ambulance, well that's up to the individual to take care of that. It's crazy. There's no political or moral or societal will to want to fix an overall healthcare problem in this country. You know, a few years back, and this is not related to EMS, but it shows the psyche. Bloomberg wanted to charge what they were calling a fat tax. If you sold sodas like in the 7-Eleven, there were 40 ounces or more. He said, you know, I would love if people were able to moderate, but in America we don't do that. You know, I was just in Europe. You can't have big things full of sugar. They're like, no, this is the proper portion of things if you want.

Newman : One of the things you said in particular resonates with me because in looking at EMS and how communities react. If there's a fire, it feels like we need to pitch-in to help. However, if there's an ambulance across the street, we kind of peek out behind the blinds and think 'the neighbor's having a heart attack. That's too bad.' There isn't that feeling of community involvement.

Almojera : There's a feeling of shame. If my house burned down or I was robbed and the cops or the firefighters helped me, the next day around the water cooler, I'm going, "Yo last night, you know, a guy broke in my house and the cops came and they took the guy, or the firefighters pulled me out and it was on fire." But I wouldn't go back around the water cooler and say I had a heart attack. Right? Because people are gonna be like, oh, Anthony had a heart attack. Uh, let me tiptoe around him. Or Anthony had a heart attack, let me take advantage. You know? Yeah. Oh, Anthony can't handle the job. He had a heart attack. It's a whole different thing.

Newman : Where do you see the future for your paramedics ? Where do you go from here?

Almojera : It's going to take persistence by a group of people. Probably the unions. Hopefully we get more people to buy-in including some politicians. You know what? I don't care if you acknowledge me. I don't care if you give me the parade. I just want the same. So if I have to be this guy in the background where people go, "Oh, you know, there's that job again, it's hard to get, but it pays really well. And look at them, they're just kind of doing their thing and you know" then so be it. That's what we'll be. Society changes. I think it's just going have to come through legislation. We have numerous lawsuits at the moment including a big one called the EEOC Equal Employment Opportunity Commission lawsuit.

Right. So either we'll force you to make it or you could come to your senses. You know, if the Mayor turned around tomorrow and said, "Hey, listen. Let's drop this lawsuit. I'll fix these things," we would be open to that conversation. But that's not going to happen. So we're just going to have to force it and just keep pushing. And then I think what will happen is people who leave, they probably will stay and that will stabilize the workforce. You'll get better. Clinicians will get that there's a job out there that you can do, where you can make a good living. The hours are flexible, et cetera, et cetera.

Newman : I've talked to so many medics who are working two and three jobs and still barely making an ends meet.

Almojera : I work three jobs. I don't have a wife and kids. And I do the three because I like to travel. I want to be able to experience things in my life. Most of the people I know work at least two jobs. And mental health doesn't exist for EMS workers. It's bare minimum. The service the department provides is a joke. In my opinion. Since since the pandemic started, I've had eight suicides in FDNY EMS alone. There's been multiple other suicides in the other agencies that operate in the 9-1-1 system.

Newman : So what is your background and how did you get into the union? You're a throwback to a different era of organized labour leader. We, we haven't seen very many fiery labour leaders in EMS for roughly 25 years.

Almojera : My dad was a longshoreman. I'd go to the union meetings with him. I watched when they were going strike and he instilled some things in me. You know, Anthony, if you give it back, you'll never get it back. Transparency. If the bosses want to be transparent, we'll help. If they don't want to be transparent, then we fight them. So there was some subtle subliminal stuff. I was born and raised in Brooklyn. I come from a very traumatic background. So in that traumatic background, if I didn't speak up, I would never get. So I learned how to be a little more assertive, but I also was very empathetic.

I didn't know where in my anywhere did I ever say I wanted to work EMS. It's just by dumb luck. I was a cook in a restaurant. I was studying theater. I wanted to be an actor. These EMTs used to come into the restaurant and I would sit there and listen to them. It was early in the morning, and they'd talk about all the calls they were on. And I'd be like, that's a good job for an actor, right? I get to go into these homes. I get to see how people live. I get to see real emotion, real situations. I could pull from that. So I thought, oh, that'd be good. And then I ask one of them, how did you become an EMT? And he told me about a school in Queens. I went to the school at Flushing Volunteer Ambulance. I became an EMT and I worked on transports and I hated it. I was like, this is not what I thought it was. It was interesting talking to people. I've always been wanting to talk to people, but I was making $9 an hour. I took a pay cut, a huge one. I was going to leave. And then I had applied to the Fire Department and right before I was going to quit, they called and I went, I'll give it a try. I went through the academy. I got out on the streets. I started working Harlem and I was like a fish in water. And that was it.

I started in the Fire Department in 2004. I became an EMT in 2002. I became a union delegate in 2006. What happened was I went to my first union meeting in 2005 and I went because there was a policy at the time called Heat Days when EMS used to bargain in the same unit with Health and Hospitals. We were part of all the office workers in that alliance. And back in the seventies when there was no air conditioning in buildings, the office workers had it in the clause that they could take a heat day when the temperature got over a certain degree, which was 90, and they would have to make it up for some reason. The city lumped us in with that. And the people who were in charge of EMS negotiating were like, fine. Except when I had to do a heat day when it's over 90 degrees, as you know, I'm expecting to not only show for work, but to be even busier.

So I didn't know anything. Nobody explained this in the Academy. Nobody tells you. So I come out, I'm an EMT in Harlem. I go to pick up some overtime and then, then afterwards I go to put in my overtime and I say to the Lieutenant, "How do you do this?" And he goes, "Well, this'll be a heat day." And I went, "What is a heat day?" And he says, "Oh, you have to work eight days for free." And the next month I was in a union meeting. What is a heat day? How come we don't have an Assistant Commissioner at EMS? And then I started getting involved. I became a delegate in 2006. So I wanted to be helpful to my fellow coworkers at the station and fight for them because they weren't part of a clique or they weren't born in a certain family. You know, at least they have somebody who will, they can turn to, you know, who says, "Hey, all right. I'll try my best to help."

Then it just took off from there. When I became an officer, a lieutenant, I decided to run for vice president because I thought about running for president of the EMT Union and I passed when I had the opportunity. And then I regretted it. So I said, I'm going to go for it. And because I think I bring to the table, like you said, a little old school flair where I'm able to speak up. I don't want anything from them. So I'm not beholden to them. We'll see where we go. I've done a lot of union work. I've done a lot of organizing but we're a fractured service and we're very broken. So there's a lot of me instead of we.

Why aren't we more people joining unions? Why aren't more people organizing? Why aren't more people saying the, the public education system that created the boom, why don't we keep that going instead of defunding that? Or, if I don't have to worry about healthcare as a part of negotiations, that frees me up. That frees everybody up. That is held over every job, public or private healthcare is dangling over you as a carrot that they're gonna take away.

So why are we sitting here still codifying a system where we allow that to happen? Why don't we look at each other, the people working the jobs, the laborers, whether you are Google or the coal miner or the medic, Hey, no, let's all fix this. Let's get universal here. Let's get it funded. You know, so this way we take away the power from them and the power from the corporations of making billions of dollars off of sickness and illness. So there's a dischord. And it's been amplified by social media where we all sit in a bubble and we don't have to do anything else. And I think in the human evolutionary process, we skip the set. We did not earn the right to engage with everybody who has different ideas and not developed a discipline to be able to engage those ideas and still come away with solutions. We've developed this thing with Twitter and Facebook and all that stuff where we've connected and we've just reinforced our biases.

And I think that's happened in labor movements and in EMS and Fire. We've created these things where we don't have to help the others out. And it's a shame because in my little echo chamber, I'm good. The people I speak to -- we're fine. Meanwhile the schools are breaking. EMS is broken.

I get members who send me TikTok videos of people saying, 'This is how you can seize every day'. No, that's not how life works. And they wanna use that. And they come to work and they have this message of 90-second salvation of your life. And then they have to come spend the other 23 hours and 58 minutes with all this minutia. And I deal with that. The workforce has become so young and everything else is so expensive that I have kids who come on this job who live at home. The city doesn't recognize how that's a problem. You know why that's a problem? Because if I'm living at home, am I beholden to you in any way, shape or form? Am I invested?

I can leave tomorrow. There's an arrested development that's happening in society. We're a microcosm of a macrocosm in EMS. So we're getting the people who come on who want to live their best lives, 90 seconds or less, 140 characters, and EMS butts up against that and says, 'No. This isn't your best life. This is ugly.' You know, there's a beauty in the ugly, but you have to stay here and you have to have people like me explain to you all the nuances of this fucked up EMS Picasso painting. This is why this makes sense and this is life but nobody's sticking around. So I'm really just speaking to you, you know, you've got more years than me. So here's this echo chamber and we're gonna try and branch it out to others. But I can't convince them if there's no skin in the game. Sometimes I get the feeling that if they see a really cool TikTok, they'll be out the door.

I went back later to finish college and I graduated, well, it's going to be two years now. Two years ago I got my Bachelor's. But when I went back to school, before the pandemic, I'm with a bunch of kids, 18 to 20. And there's an anxiety there that I didn't have. I had my own anxieties, but not the same anxieties that they had. And what I realized is the 9-1-1 generation, it's kids that grew up, they knew 20 years of war, three economic downturns, other wars throughout the world, and now a pandemic, right? So their mentality is, if it doesn't happen now, it'll never happen. And they see that as they wake up every morning, it's reinforced that mentality. The price of homes have gone up and medical care has gone up. And the price of this is, and the ability to do this is – and the climate's going to hell.

So, I have to live my life. I need to live my best life so I can put it on social media, validate it and everything else. And that's an anxiety I didn't have. Because, you know, when you and I were growing up, if you wanted to know bad things that were happening in the world, you had to be home at 6:30 and watch a certain news program or you had to get a certain newspaper. There was effort. So you got to live in this little slice of innocence and develop ways to cope. As that information trickled in. Now it is on your phone. What do you mean get involved with the union? The world's not going be here in 20 years.

Newman : Can you tell me about the FDNY EMS Help Fund ?

Almojera :  The Help Fund was started because in the Fire Department there was only the Honor emergency fund. And what happened was a lot of EMS members did not have access to that. They weren't helping them. So we realized that there was a need. The idea came out to start this Help Fund. And then we realized there's a need for assisting people who are in crisis. EMS members get 12 sick days a year. Fire, PD, Sanitation, Corrections get unlimited sick leave. So you have tons of EMS members who get sick because they deal with sick people, run out of sick time, go off payroll, lose their benefits, and then are destitute. So they have to have someplace to turn to just give them a lifeline for a little bit. And that's what the Help Fund does. It can't fix everything. It just gives you a flotation device for a month or two.

Newman : Yadira Arroyo, a FDNY EMT, was murdered on the job in March 2017. She was working overtime on a day when she was supposed to be off. Arroyo was a mother of five. What happened to her children in the years since their mother's death ?

Almojera : Yes, she had five children. Some of them were a little older. I think some of them are living with the family. They're all living with the family. She had a large family, so, you know, she was lucky that way. One of her sons came on the job, one of them is an EMT with us. He was given her shield. They retired her shield and then he got her shield. He's assigned to the Bronx. I'm in Brooklyn so I don't really come across him that much, but very nice kid. He kind of grew up in all this.

Newman : And what happened to her partner? Did she ever return to the job?

Almojera : No. She never did.

Newman : Is PTSD recognized as a work-related disorder for FDNY medics?

Almojera : There have been people who have been able to go out disability psychiatric, but man, that is hard. I think it has to be traumatic, like watching your partner get killed or something like that. Mental health problems on this job are not really supported or recognized. And it's ironic because we run the mental health units, where we do these outreaches to try and mitigate people so that they can get early intervention without police and burning out the system. But there's no early intervention for us. I was speaking to one of the therapists who was working in that unit and she was telling me how the EMTs she's working with, she feels like she's starting to treat them because they're talking, they're sitting in a truck, you know, for eight hours and you remember -- your partner becomes your therapist.

Newman : If you could change three things about life as a medic in NYC what would your screaming priorities be ?

Almojera : Finance, equality, economic and beneficial equality with the other services, mental healthcare for the medics. Because if I'm struggling how do I focus on getting mental healthcare? But, so I want to increase the pay and benefits so that the only job you need is to be a medic. If I was ruler of EMS, I would mandate that not only is therapy mandatory, but every six months you have to go in and check-in for a full physical, not every year. I'd get us off the street corners. EMTs and medics are sitting on street corners to try and get to the jobs quicker. And they're dispatched from street corners. That is unhealthy. It is dangerous, it's antiquated and it's ineffective because they're never really serving their communities because they're getting pulled all over the boroughs because we're so busy and we're short staffed.

In the United States, teachers get a sabbatical. Soldiers can only do six months and have to cycle out of zones. But you're telling a paramedic or an EMT that for 25 years you're into The Suck. I would want some way to cycle out of responding to calls all day. Because really in PD and Fire, you have other avenues you can work on. They both have navies, one has a mounted horse unit, community relations, fire inspectors, fire marshals.

And then there's EMS. We only have one thing.